Helpful terms to understand insurance plan provisions.
To Adelphi University Medical Plan Participants with United Healthcare
Since we made some changes to the Medical Plans with United Healthcare beginning January 2017, we thought it would be helpful to define some terms to understand plan provisions.
Claim– A request for payment that you submit to your health insurance carrier when you receive items and services that you think are covered.
Coinsurance – An amount you may be required to pay as your share of the cost for services, after you pay any deductibles. Coinsurance is usually a percentage (for example, 20%)
Copayment – An amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor’s visit, hospital outpatient visit, or a prescription drug. A copayment is usually a set amount, rather than a percentage. For example, you might pay $25 or $35 for a doctor’s visit or prescription.
Deductible – The amount of out-of-pocket expenses that must be paid for health services before becoming payable by the carrier.
Out-of-Pocket Maximum (MOOP) – is the most you’ll have to pay during a policy period (usually a year) for health care services. Once you’ve reached your out-of-pocket maximum, your plan begins to pay 100 percent of the allowed amount for covered services.
Health Reimbursement Account (HRA) – If you are covered by Adelphi’s medical plan with United Healthcare, you can use the HRA Visa Debit Card to pay eligible health care expenses for yourself, your spouse and your dependents. Reminder: The HRA is a tax favored account fully funded by Adelphi. To learn more, call ADP 1.800.678.6684 or view your profile at myspendingaccount.adp.com.
For Employees Who Have Questions Regarding Medicare
See resources below.
Medicare: For information and personal help on coverage issues, Call Medicare’s help line at 800.633.4227. or visit medicare.gov.
Social Security: For information and personal help signing up for Medicare or applying for Extra Help benefits in the Part D drug program, call 800.772.1213 or visit ssa.gov.
Adult Fitness Program Special Offer for Spring 2017
The Exercise Science Department is offering free membership to the first 30 full-time Adelphi employees who submit the registration forms and physician’s clearance form.
This 12-week program offers an individualized approach with tailored exercise programs, nutrition counseling, and recreational activities.
A team that includes exercise physiologists and staff members certified by the American College of Sports Medicine performs comprehensive fitness evaluations and develops individualized programs. Participants are motivated to achieve their fitness goals as they learn how to exercise properly, efficiently, and safely.
Membership is contingent upon the approval of your personal physician. A physician’s clearance form must be submitted in order to participate in the exercise program.
Find the registration forms at education.adelphi.edu/adult-fitness.